Caglar Recep, Yuzbasioglu Mehmet Fatih, Bulbuloglu Ertan, Gul Mustafa, Ezberci Fikret, Kale Ilhami Taner
Department of General Surgery, Faculty of Medicine, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey.
J Invest Surg. 2008 Mar-Apr;21(2):71-5. doi: 10.1080/08941930701883640.
In the surgical history of hepatic hydatid disease, multiple scolicidal agents have been used for sterilization of the cyst contents. However, none of these agents can be safely used, because most have unacceptable side effects, such as toxicity, caustic sclerosing cholangitis, bile duct stricture, and hypernatremia. Protoscolices were aseptically removed from liver hydatid cysts obtained from sheep slaughtered at the municipal abattoir in Kahramanmaras, Turkey. In this study, the effects of 0.9% NaCl (control group), 20% NaCl (hypertonic saline), 20% silver nitrate, albendazole 20 mg/cm3, 50% dextrose (hypertonic glucose), and 20% mannitol and aminomix-1 solutions on echinococe cysts were investigated under in vitro conditions. After 5, 10, 15, 20, 25, 30, 45, and 60 min for each concentration, the first 100 protoscolices were counted on the 10x microscopical field. Protoscolices, which showed positive staining by eosine were considered as dead ones. The averages of dead and total protoscolices were calculated. Our results showed that all observed protoscolices were dead after the treatments by 20% silver nitrate in 20 min, by 50% dextrose and by aminomix-1 solution in 30 min, and by 20% NaCl and by 20% mannitol in 45 min. Albendazole at 20 mg/cm3 was observed to lead to death of 65% of protoscolices in the first 5 min and 70% of protoscolices at the end of 60 min. Compared with 0.9% NaCl (saline), all of these scolicidal agents were significantly effective (p < .05). Aminomix-1, 20% mannitol, and 50% dextrose solutions may be used in percutaneous and surgical treatment of hydatid cyst. They may be preferred because they are readily available, can be administered intravenously, and have an equal or greater effectiveness than 20% hypertonic saline.
在肝包虫病的外科治疗史上,多种杀头节剂已被用于使囊内容物失活。然而,这些药剂都不能安全使用,因为大多数都有不可接受的副作用,如毒性、腐蚀性硬化性胆管炎、胆管狭窄和高钠血症。从土耳其卡赫拉曼马拉什市屠宰场宰杀的绵羊所获得的肝包虫囊肿中无菌取出原头节。在本研究中,在体外条件下研究了0.9%氯化钠(对照组)、20%氯化钠(高渗盐水)、20%硝酸银、20mg/cm³阿苯达唑、50%葡萄糖(高渗葡萄糖)、20%甘露醇和氨基混合液-1溶液对棘球蚴囊肿的影响。对于每种浓度,在5、10、15、20、25、30、45和60分钟后,在10倍显微镜视野下对前100个原头节进行计数。伊红染色呈阳性的原头节被视为死亡。计算死亡原头节和总原头节的平均值。我们的结果表明,在处理后,所有观察到的原头节在20分钟内被20%硝酸银杀死,在30分钟内被50%葡萄糖和氨基混合液-1溶液杀死,在45分钟内被20%氯化钠和20%甘露醇杀死。观察到20mg/cm³阿苯达唑在最初5分钟内导致65%的原头节死亡,在60分钟结束时导致70%的原头节死亡。与0.9%氯化钠(生理盐水)相比,所有这些杀头节剂都具有显著效果(p<0.05)。氨基混合液-1、